AI
Tuesday, January 12, 2016 8:38:48 PM
Obamacare’s Success Hinges on States
The Affordable Care Act loses Kentucky but gains Louisiana.
Louisiana Gov. John Bel Edwards greets the crowd after taking the oath of office on
Monday. Edwards has vowed to expand Medicaid in the state.
By Kimberly Leonard
Jan. 12, 2016, at 4:15 p.m.
+ More
Within 24 hours, Obamacare .. http://www.usnews.com/news/blogs/data-mine/2015/03/23/5-numbers-to-know-for-obamacares-5-year-anniversary .. lost one convert and gained another.
On Monday, newly sworn-in Republican Gov. Matt Bevin of Kentucky said the commonwealth would be chucking its exchange, which had been held up by the White House as a prime example of how to carry out President Barack Obama's health care law, the Affordable Care Act. The exchange, called Kynect, has enrolled 87,000 in tax-subsidized, private health insurance .. http://health.usnews.com/health-insurance , but under the repeal Kentuckians will have to get coverage in the federal markeplace, Healthcare.gov.
That same day, in Louisiana, Democratic Gov. John Bel Edwards announced during his inaugural address that Tuesday he would be accepting federal funding for expanding Medicaid .. http://www.usnews.com/news/the-report/articles/2015/12/04/opposing-medicaid-expansion , the government's program for low-income Americans that is expected to cover 422,000 additional state residents. The former governor, Bobby Jindal, who dropped out .. http://www.usnews.com/news/articles/2015/11/17/bobby-jindal-drops-out-of-2016-presidential-race .. of the race for the Republican presidential nomination .. http://www.usnews.com/news/the-chase .. in November, had vehemently opposed expansion.
RELATED
Opposing Medicaid Expansion
http://www.usnews.com/news/the-report/articles/2015/12/04/opposing-medicaid-expansion
"Your tax dollars shouldn't go to other states that have expanded Medicaid when Louisiana is one of the states that expansion will help the most," Edwards said during his address, promising to roll out the program by July 1.
The move is a major victory for the administration as it continues to push for expansion under Obamacare. Even Bevin has backed off the anti-Medicaid rhetoric of his campaign, saying he wants to reform Medicaid in Kentucky rather than repeal the expansion created by his predecessor, Democratic Gov. Steve Beshear.
The developments illustrate the important role states play in carrying out the major tenets of Obamacare. In choosing whether to create their own marketplaces and whether to expand Medicaid, they are effectively deciding how to cover their most vulnerable residents, and their decisions impact how many people will continue to go without insurance.
Democrats included the option of running state exchanges when writing Obamacare, believing the provision would encourage more Republicans to support the law. In the end, however, most states did not establish their own exchanges, but allowed the federal version to take effect.
"When the Affordable Care Act was written, I think the lawmakers did not at all expect states to give so much pushback in terms of creating their own exchanges – I think they thought they would want to," says Louise Norris, a health insurance broker who writes for HealthInsurance.org.
RELATED
Obama Vetoes Budget Bill that Would Have Repealed Obamacare
http://www.usnews.com/news/articles/2016/01/12/for-obamacare-who-is-running-states-matters
While some states, like Kentucky, saw tremendous success from creating their own exchanges, other states exchanges – including those in Oregon, Nevada and Hawaii – flopped and shuttered. Massachusetts and Maryland were eager supporters of Obamacare, but creating their own exchanges proved more difficult than anticipated, as both faced significant technical glitches and had to hire new information technology forces. After Kentucky, only 12 states and the District of Columbia .. http://www.ncsl.org/research/health/state-actions-to-implement-the-health-benefit.aspx .. will operate their own exchanges. The rest are reliant on Healthcare.gov.
"As states saw the great failures of other states, it made some leaders very nervous," says David K. Jones, assistant professor at Boston University's School of Public Health. "They think, 'Why go through extra work and trouble?' The federal exchange is getting better and better .. http://www.usnews.com/news/articles/2015/10/23/obamacare-website-gets-a-facelift .. every year."
Obamacare was shaken by Supreme Court decisions that have obstructed its ability to work uniformly across states. First, the Supreme Court ruled in 2012 that states could decide on their own .. http://www.usnews.com/news/articles/2014/11/05/us-voters-say-no-to-obamacare-medicaid-expansion .. whether they wanted to expand Medicaid .. http://www.usnews.com/news/articles/2015/02/24/medicaid-enrollment-surges-across-the-us .. to cover Americans making less than $16,000 for an individual – a provision that Obamacare initially intended for all states. The result of the decision has left 20 states without expansion at this time, meaning that millions remain uninsured .. http://www.usnews.com/news/blogs/data-mine/2015/03/16/obamacare-makes-historic-headway-in-boosting-insurance-coverage .
30 states and the District of Columbia have decided to expand Medicaid under Obamacare.
Under Obamacare, the federal government initially picks up the full tab for additional Medicaid enrollees but gradually lowers its support to 90 percent over time, leaving some lawmakers concerned about how to pay for the program over the long term.
In 2014, the Supreme Court ruled again on Obamacare, deciding in King v. Burwell .. http://www.usnews.com/news/articles/2015/06/25/supreme-court-upholds-obamacare-subsidies-in-king-v-burwell .. that people could receive tax subsidies to pay for health insurance even if they bought it through Healthcare.gov. The case was brought because of unclear language in the law that appeared to specify that states had to establish their own exchanges for their residents to receive tax subsidies.
Though considered a win for the administration, the decision further openened the possibility that states would default to using Healthcare.gov .. http://www.usnews.com/news/articles/2015/06/25/despite-scotus-ruling-challenges-remain-for-obamacare .. rather than create their own exchanges. States that run their own exchanges can control the role of agents and brokers, better link residents with Medicaid and other state-run programs, and tailor the program specifically to the social and economic needs of their residents. In states where Obamacare is viewed particularly unfavorably, health care agencies can frame the exchange as state-based, perhaps encouraging more people to enroll who might be skeptical of the massive federal law.
"There is far more control at the state level now than was even remotely expected when the law passed," Norris says.
States also can begin anticipating another provision in Obamacare that begins in 2017, called Section 1332. States that run their own exchanges will be able to ask the federal government to waive many of the requirements in the Affordable Care Act so they can create their own systems. Voters in Colorado, for instance, will be asked in a ballot initiative next year to consider a single-payer model.
In his decision to undo Kynect, Bevin said the system is "redundant." He sent a letter about his intentions to the Department of Health and Human Services on Dec. 30, which was made public Monday. Ben Wakana, spokesman for the U.S. Department of Health and Human Services, said in an email that the federal government was committed to a "seamless transition."
RELATED
An Obamacare Provision Even Republicans Can Love
http://www.usnews.com/news/articles/2016/01/06/an-obamacare-provision-even-republicans-can-love
Linda Blumberg, senior fellow in the Health Policy Center at the Urban Institute, says state-based exchanges have the ability to cater to their citizens' needs in a way that is difficult for the federal government. "Allowing some state ownership and flexibility seemed like a positive component of the law," she says.
Dismantling Kynect isn't politically risky for Bevin. It allows him to fulfill the promise to "repeal Obamacare" that he ran his campaign on, Jones says. While the federal exchange isn't as customized for residents as Kynect, it still guarantees that enrollees will be able to continue receiving the same tax subsidies that made insurance more affordable.
He adds that the irony is that health insurance exchanges were originally devised by Republicans, and state authority is largely touted as a Republican ideal.
"The fact that not a single Republican in Congress supported the Affordable Care Act set the tone for states," Jones says. "It became very hard for GOP leaders to nuance this as, 'We are not doing Obamacare, but a state-based version of this.'"
[YouTube of embed]
http://www.usnews.com/news/articles/2016/01/12/for-obamacare-who-is-running-states-matters
See also:
300,000 Low-Income Louisianians Gained Healthcare Today As Bobby Jindal Is Replaced By Democratic Governor
http://investorshub.advfn.com/boards/read_msg.aspx?message_id=119790891
Kentucky Gov. Matt Bevin begins process of undoing state's remarkable healthcare success
http://investorshub.advfn.com/boards/read_msg.aspx?message_id=119791024
Republican National Debt: $12 Trillion and Counting
[plus interest]
The debt went up during Clinton's years only because of $2.2 Trillion interest on the Reagan-Bush debt.
Otherwise Clinton would have paid off most the remaining WWII debt. G.W.Bush got sand-bagged by Reagan.
http://investorshub.advfn.com/boards/read_msg.aspx?message_id=80292261
The Affordable Care Act loses Kentucky but gains Louisiana.
Louisiana Gov. John Bel Edwards greets the crowd after taking the oath of office on
Monday. Edwards has vowed to expand Medicaid in the state.
By Kimberly Leonard
Jan. 12, 2016, at 4:15 p.m.
+ More
Within 24 hours, Obamacare .. http://www.usnews.com/news/blogs/data-mine/2015/03/23/5-numbers-to-know-for-obamacares-5-year-anniversary .. lost one convert and gained another.
On Monday, newly sworn-in Republican Gov. Matt Bevin of Kentucky said the commonwealth would be chucking its exchange, which had been held up by the White House as a prime example of how to carry out President Barack Obama's health care law, the Affordable Care Act. The exchange, called Kynect, has enrolled 87,000 in tax-subsidized, private health insurance .. http://health.usnews.com/health-insurance , but under the repeal Kentuckians will have to get coverage in the federal markeplace, Healthcare.gov.
That same day, in Louisiana, Democratic Gov. John Bel Edwards announced during his inaugural address that Tuesday he would be accepting federal funding for expanding Medicaid .. http://www.usnews.com/news/the-report/articles/2015/12/04/opposing-medicaid-expansion , the government's program for low-income Americans that is expected to cover 422,000 additional state residents. The former governor, Bobby Jindal, who dropped out .. http://www.usnews.com/news/articles/2015/11/17/bobby-jindal-drops-out-of-2016-presidential-race .. of the race for the Republican presidential nomination .. http://www.usnews.com/news/the-chase .. in November, had vehemently opposed expansion.
RELATED
Opposing Medicaid Expansion
http://www.usnews.com/news/the-report/articles/2015/12/04/opposing-medicaid-expansion
"Your tax dollars shouldn't go to other states that have expanded Medicaid when Louisiana is one of the states that expansion will help the most," Edwards said during his address, promising to roll out the program by July 1.
The move is a major victory for the administration as it continues to push for expansion under Obamacare. Even Bevin has backed off the anti-Medicaid rhetoric of his campaign, saying he wants to reform Medicaid in Kentucky rather than repeal the expansion created by his predecessor, Democratic Gov. Steve Beshear.
The developments illustrate the important role states play in carrying out the major tenets of Obamacare. In choosing whether to create their own marketplaces and whether to expand Medicaid, they are effectively deciding how to cover their most vulnerable residents, and their decisions impact how many people will continue to go without insurance.
Democrats included the option of running state exchanges when writing Obamacare, believing the provision would encourage more Republicans to support the law. In the end, however, most states did not establish their own exchanges, but allowed the federal version to take effect.
"When the Affordable Care Act was written, I think the lawmakers did not at all expect states to give so much pushback in terms of creating their own exchanges – I think they thought they would want to," says Louise Norris, a health insurance broker who writes for HealthInsurance.org.
RELATED
Obama Vetoes Budget Bill that Would Have Repealed Obamacare
http://www.usnews.com/news/articles/2016/01/12/for-obamacare-who-is-running-states-matters
While some states, like Kentucky, saw tremendous success from creating their own exchanges, other states exchanges – including those in Oregon, Nevada and Hawaii – flopped and shuttered. Massachusetts and Maryland were eager supporters of Obamacare, but creating their own exchanges proved more difficult than anticipated, as both faced significant technical glitches and had to hire new information technology forces. After Kentucky, only 12 states and the District of Columbia .. http://www.ncsl.org/research/health/state-actions-to-implement-the-health-benefit.aspx .. will operate their own exchanges. The rest are reliant on Healthcare.gov.
"As states saw the great failures of other states, it made some leaders very nervous," says David K. Jones, assistant professor at Boston University's School of Public Health. "They think, 'Why go through extra work and trouble?' The federal exchange is getting better and better .. http://www.usnews.com/news/articles/2015/10/23/obamacare-website-gets-a-facelift .. every year."
Obamacare was shaken by Supreme Court decisions that have obstructed its ability to work uniformly across states. First, the Supreme Court ruled in 2012 that states could decide on their own .. http://www.usnews.com/news/articles/2014/11/05/us-voters-say-no-to-obamacare-medicaid-expansion .. whether they wanted to expand Medicaid .. http://www.usnews.com/news/articles/2015/02/24/medicaid-enrollment-surges-across-the-us .. to cover Americans making less than $16,000 for an individual – a provision that Obamacare initially intended for all states. The result of the decision has left 20 states without expansion at this time, meaning that millions remain uninsured .. http://www.usnews.com/news/blogs/data-mine/2015/03/16/obamacare-makes-historic-headway-in-boosting-insurance-coverage .
30 states and the District of Columbia have decided to expand Medicaid under Obamacare.
Under Obamacare, the federal government initially picks up the full tab for additional Medicaid enrollees but gradually lowers its support to 90 percent over time, leaving some lawmakers concerned about how to pay for the program over the long term.
In 2014, the Supreme Court ruled again on Obamacare, deciding in King v. Burwell .. http://www.usnews.com/news/articles/2015/06/25/supreme-court-upholds-obamacare-subsidies-in-king-v-burwell .. that people could receive tax subsidies to pay for health insurance even if they bought it through Healthcare.gov. The case was brought because of unclear language in the law that appeared to specify that states had to establish their own exchanges for their residents to receive tax subsidies.
Though considered a win for the administration, the decision further openened the possibility that states would default to using Healthcare.gov .. http://www.usnews.com/news/articles/2015/06/25/despite-scotus-ruling-challenges-remain-for-obamacare .. rather than create their own exchanges. States that run their own exchanges can control the role of agents and brokers, better link residents with Medicaid and other state-run programs, and tailor the program specifically to the social and economic needs of their residents. In states where Obamacare is viewed particularly unfavorably, health care agencies can frame the exchange as state-based, perhaps encouraging more people to enroll who might be skeptical of the massive federal law.
"There is far more control at the state level now than was even remotely expected when the law passed," Norris says.
States also can begin anticipating another provision in Obamacare that begins in 2017, called Section 1332. States that run their own exchanges will be able to ask the federal government to waive many of the requirements in the Affordable Care Act so they can create their own systems. Voters in Colorado, for instance, will be asked in a ballot initiative next year to consider a single-payer model.
In his decision to undo Kynect, Bevin said the system is "redundant." He sent a letter about his intentions to the Department of Health and Human Services on Dec. 30, which was made public Monday. Ben Wakana, spokesman for the U.S. Department of Health and Human Services, said in an email that the federal government was committed to a "seamless transition."
RELATED
An Obamacare Provision Even Republicans Can Love
http://www.usnews.com/news/articles/2016/01/06/an-obamacare-provision-even-republicans-can-love
Linda Blumberg, senior fellow in the Health Policy Center at the Urban Institute, says state-based exchanges have the ability to cater to their citizens' needs in a way that is difficult for the federal government. "Allowing some state ownership and flexibility seemed like a positive component of the law," she says.
Dismantling Kynect isn't politically risky for Bevin. It allows him to fulfill the promise to "repeal Obamacare" that he ran his campaign on, Jones says. While the federal exchange isn't as customized for residents as Kynect, it still guarantees that enrollees will be able to continue receiving the same tax subsidies that made insurance more affordable.
He adds that the irony is that health insurance exchanges were originally devised by Republicans, and state authority is largely touted as a Republican ideal.
"The fact that not a single Republican in Congress supported the Affordable Care Act set the tone for states," Jones says. "It became very hard for GOP leaders to nuance this as, 'We are not doing Obamacare, but a state-based version of this.'"
[YouTube of embed]
http://www.usnews.com/news/articles/2016/01/12/for-obamacare-who-is-running-states-matters
See also:
300,000 Low-Income Louisianians Gained Healthcare Today As Bobby Jindal Is Replaced By Democratic Governor
http://investorshub.advfn.com/boards/read_msg.aspx?message_id=119790891
Kentucky Gov. Matt Bevin begins process of undoing state's remarkable healthcare success
http://investorshub.advfn.com/boards/read_msg.aspx?message_id=119791024
Republican National Debt: $12 Trillion and Counting
[plus interest]
The debt went up during Clinton's years only because of $2.2 Trillion interest on the Reagan-Bush debt.
Otherwise Clinton would have paid off most the remaining WWII debt. G.W.Bush got sand-bagged by Reagan.
http://investorshub.advfn.com/boards/read_msg.aspx?message_id=80292261
It was Plato who said, “He, O men, is the wisest, who like Socrates, knows that his wisdom is in truth worth nothing”
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